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Related Experiment Videos

Calcium antagonists for ischemic stroke: a systematic review.

J Horn1, M Limburg

  • 1Department of Neurology, Academic Medical Center, University of Amsterdam (Netherlands). jhorn@wxs.nl

Stroke
|February 7, 2001
PubMed
Summary

Calcium antagonists do not reduce death or dependency after acute ischemic stroke. Analysis of published trials showed no significant effect, though unpublished and high-quality studies suggested a potential benefit.

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Area of Science:

  • Neurology
  • Clinical Trials
  • Pharmacology

Background:

  • Stroke is a leading cause of death and disability worldwide.
  • Calcium antagonists have been investigated for neuroprotective effects in stroke.
  • Numerous clinical trials have explored their efficacy.

Purpose of the Study:

  • To systematically review randomized trials on calcium antagonists for acute ischemic stroke.
  • To determine if calcium antagonists reduce the risk of death or dependency.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Inclusion of published and unpublished trials investigating voltage-sensitive calcium channel blockers.
  • Primary outcome: poor outcome (death or dependency); secondary outcome: death.

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Main Results:

  • Twenty-nine trials (7665 patients) were included in the analysis.
  • No significant effect of calcium antagonists on poor outcome (RR 1.04, 95% CI 0.98-1.09) or death (RR 1.07, 95% CI 0.98-1.17).
  • Sensitivity analyses and subgroup analyses (unpublished/methodologically sound trials) revealed potential benefits, contrasting with published/lower-quality trials.

Conclusions:

  • Clinically significant benefits of calcium antagonists in acute ischemic stroke are unlikely.
  • Robust statistical evidence suggests no overall benefit, despite some subgroup findings.
  • Further investigation into specific subgroups may be warranted but overall efficacy is questionable.